Anjali Sharma

Human Infection Challenge studies (HICs) are crucial for advancing global understanding of disease pathogenesis, immune responses, and accelerating vaccine and drug development. Explorations on willingness to participate among medical students revealed the need to ensure full understanding of HIC requirements, for example, for residency, by the broader community. This raised the question of ‘How could we ensure informed and understood consent for the ethical conduct of HIC?’ We employed iterative participatory discovery and creative design methods, including three Zoom meetings and discussions with university students and community leaders. Neighbourhood Health Committee leaders further refined suggested creatives of a future mass-media campaign for building trust in HICs. Deliberative focus group discussions and workshops were conducted on communication strategies on HICs’ requirements, risks, requirements, and benefits. The final creative brief suggested (1) using a pyramid approach utilizing existing community structures, to introduce HIC concepts progressively to larger groups, (2) engaging communities through theatre for development, community dialogue, and engagement meetings, and wide society through social and mass media advertisements, and (3) preference for the term ‘Human Challenge Studies’ over ‘Human Infection Challenge Studies’. We learned that community engagement, if properly conducted, can create systems of ownership of research and build communication strategies to achieve an accurate understanding of HICs and use informed participation that results in trustworthy data. We need further research, including in rural areas, pilot testing of evaluation strategies, and continued engagement with diverse stakeholders to create products that can be adapted by future HIC studies in settings such as Zambia.

The present study focused on exploring the health, hygiene, and educational conditions of tribal women from the Upper Bonda tribal community in the Malkangiri region of Odisha, India. A descriptive survey was used to carry out the research. A purposive stratified random sampling technique was adopted to select sixty tribal women as participants, and other stakeholders, i.e., Doctors, health workers, and teachers, are also included. A semistructured interview schedule was developed, and face-to-face interviews were conducted during field visits. The data collected were analyzed using percentage and thematic analysis techniques. The significant findings indicated that menstrual health, hygiene issues, and diseases like malaria, typhoid, and genetic conditions significantly affected most women. The low literacy rates among Upper Bonda tribal women were linked to a lack of awareness and financial support. The inaccessibility of schools and insufficient parental support explain why tribal girls often cannot receive proper education or tend to drop out early. The findings were further corroborated through discussions with teachers, doctors, and Asha workers about the prevalent health, hygiene, and educational standards among Upper Bonda tribal women. It can be concluded that the absence of financial assistance and awareness dramatically contributes to the lower literacy rates and declining health status among Upper Bonda tribal women. The Central and State Governments must revise the POSHAN Abhiyaan nutrition policy and the Integrated Child Development Services (ICDS) policy, among other initiatives. Imp

The escalating global environmental issues highlight a significant deficiency in teacher education concerning pre-service teachers' competencies in addressing environment sensitive issues. In educational settings, contemporary techniques predominantly focus on attitudes, neglecting crucial elements such as environmental knowledge and skills. The present study aims to create and validate a standardized assessment scale, the Environmental Knowledge, Attitude, and Skill (EKAS) Scale, to comprehensively assess pre service teachers' competencies regarding environmental issues. Data were collected from 378 third-year pre-service teachers in science and social science disciplines at a teacher education institute utilizing a purposive sampling method. The EKAS Scale comprises 82 multiple-choice items and was developed and verified in a five-step procedure that included expert feedback, item validation, and reliability testing, yielding a Cronbach's alpha of 0.80. The scale assesses teachers' competencies in three significant domains: understanding of environmental content knowledge, attitudes toward the environment, and environmental skill. The findings indicate that a considerable percentage of pre-service teachers exhibit insufficient knowledge (55.03%), limited environmental skills (45.76%), and unfavorable attitudes (47.09%) regarding environment-sensitive issues. Furthermore, pre-service teachers in the science stream achieved significantly higher scores than those in the social science stream, indicating notable differences in environmental competency across disciplines. The conclusions underscore the need for interdisciplinary incorporation of environment-sensitive issues in teacher preparation courses. The EKAS Scale offers a comprehensive framework for informing curriculum development, directing professional training, and shaping legislative reforms to improve environmental literacy among future educators. The present assessment tool can cultivate proficient, environmentally conscious instructors capable of imparting sustainable perspectives to future generations.

© 2015 Elsevier Inc. β-adrenergic signaling pathways mediate key aspects of cardiac function. Its dysregulation is associated with a range of cardiac diseases, including dilated cardiomyopathy. Previously, we established an iPSC model of familial DCM from patients with a mutation in TNNT2, a sarcomeric protein. Here, we found that the β-adrenergic agonist isoproterenol induced mature β-adrenergic signaling in iPSC-derived cardiomyocytes but that this pathway was blunted in DCM iPSC-CMs. Although expression levels of several β-adrenergic signaling components were unaltered between control and DCM iPSC-CMs, we found that phosphodiesterases 2A and PDE3A were upregulated in DCM iPSC-CMs and that PDE2A was also upregulated in DCM patient tissue. We further discovered increased nuclear localization of mutant TNNT2 and epigenetic modifications of PDE genes in both DCM iPSC-CMs and patient tissue. Notably, pharmacologic inhibition of PDE2A and PDE3A restored cAMP levels and ameliorated the impaired β-adrenergic signaling of DCM iPSC-CMs, suggesting therapeutic potential. In this paper, Wu etal. profiled the β-adrenergic signaling properties in human iPSC-CMs and demonstrated novel epigenetic mechanisms that underlie the compromised β-adrenergic signaling in DCM, a common cause of heart failure and cardiac transplantation. These results enhance our understanding of DCM pathogenesis and may uncover new therapeutic targets.

Amit Sharma, Rajesh Ramanathan, Marc Posner, Robert A Fisher Hume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USA: Pediatric kidney transplantation is the preferred treatment for children with end-stage renal disease. The most common indications for transplantation in children are renal developmental anomalies, obstructive uropathy, and focal segmental glomerulosclerosis. Living donor kidney transplants are often performed pre-emptively and offer excellent graft function. Policy changes in deceased-donor kidney allocation have increased the proportion of such transplants in pediatric recipients. Adequate pretransplant workup along with evaluation of urologic abnormalities is imperative in achieving good outcomes. Overall, patient and graft outcomes after kidney transplantation have improved, with five-year deceased donor and living donor graft survivals of 78.8% and 84.3%, respectively. Improvements in induction and maintenance immunosuppression have contributed to the gradual improvement in outcomes. Unique challenges in pediatric recipients include increased graft thrombosis, adverse growth, and abnormal development relating to immunosuppression, increased rejection due to nonadherence, increased susceptibility to opportunistic infections, and post-transplant malignancy. This review focuses on the current practices and outcomes in pediatric kidney transplantation in North America. We discuss the indications for transplantation, the evaluation process, some key surgical and immunologic considerations, and the common risk factors for graft dysfunction. Keywords: pediatric kidney transplantation, end-stage renal disease, dialysis, organ donors, immunosuppression.